3429 15TH ST 2017-06-07 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: .+a W J$" XW ZO/ BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED 13 SFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS COMMERCIAL USE OF BUILDING: '-"vo:yJ ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ C U NUMBER OF DEVICES if low voltage): FIRE ALARM? t YES ❑NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: Z ?t,J/� �*4 ��7� 6^1 �/E' :✓� j CONTACT INFORMATION OWNER NAME: C' TENANT NAME it Commercial): 1 /�Y OWNER MAILING ADDRESS: STREETy�3�T—`�=yg— /S r" 5� CITY ri V'�'i'jC( STATE 61-0 zip Z d+ OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: /'JW CONTRACTOR ADDRESS: STREET G� CITY gle'.4.1 STATE WA ZIP CONTRACTOR PHONE: 2-5�? 277--i` Yf CONTRACTOR EMAIL: ►- CONTRACTOR LIC.#(REQUIRED): CUMA,l l Q-r-?t_ y CITY OF EVERETT BUSINESS LIC.#(REQUIR4 D):(/PC&0—yf 7� 1 PRIMARY CONTACT: ❑OWNER }$'CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACTPHONE: r0>ft�trh CONTACT EMAIL:: cot AGREEMENT.Thereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Paws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That f am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18 27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# Owner/ uthorizod Agent Signa re date (Revised 90/12/2015)